Provider Demographics
NPI:1669978326
Name:BEIG, KELSEA (DPT)
Entity type:Individual
Prefix:
First Name:KELSEA
Middle Name:
Last Name:BEIG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5298
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2465
Mailing Address - Country:US
Mailing Address - Phone:928-782-5588
Mailing Address - Fax:928-782-5755
Practice Address - Street 1:2244 S AVENUE A STE E
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8341
Practice Address - Country:US
Practice Address - Phone:928-782-5588
Practice Address - Fax:928-782-5755
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist